A.B. Page 2 6 October 2009

Neuropsychological Evaluative Comparison

Name: Veteran # 2 A.B. Status: Outpatient Pilot Study

Date of Birth: Age: 32

Dates of Contact: 12 September, 6 October 2009

Date of This Note: 14 October 2009

A.B. has been seen as part of a pilot study for the hyperbaric treatment of traumatically brain injured serviceman conducted through Cralle Physical Therapy Services, P.A. A.B. had been seen to determine neurocognitive and psychological test performance pre- and post- hyperbaric treatments.

TESTS ADMINSTERED:

Medical Symptom Validity Test (MSVT); Wechsler Test of Adult Reading (WTAR); Wechsler Adult Intelligence Scale – III (WAIS-III: Digit Span, Arithmetic, Letter-Number Sequencing, Digit Symbol – Coding, Digit Symbol – Copy, Symbol Search, Similarities); Boston Naming Test; Brief Visuospatial Memory Test – Revised Forms 1 & 2; Rey Complex Figure Test; California Verbal Learning Test – II (CVLT-II) Standard/Alternate Forms; Trail Making Test Parts A & B; Delis Kaplan Executive Function System (DKEFS) Verbal Fluency; Beck Depression Inventory – II (BDI-II); State-Trait Anxiety Inventory; PTSD Checklist – Civilian Version (PCL-C); Minnesota Multiphasic Personality Inventory – 2 (MMPI-2); Lateral Dominance Examination; Finger Tapping Test; Grip Strength; Grooved Pegboard.

For the purposes of interpretation and communicating results, the following descriptors will be used:

Average 45t to 54t; 30th – 69th percentile

Below Average 40t to 44t; 16th – 29th percentile

Mildly Impaired 35t to 39t; 7th – 15th percentile

Mildly to Moderately Impaired 30t to 34t; 2nd – 6th percentile

Moderately Impaired 25t to 29t; 1st – 2nd percentile

Moderately to Severely Impaired 20t to 24t; within 1st percentile

Severely Impaired below 20t; within 1st percentile

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Note: t scores have a mean of 50 and standard deviation of 10

The same set of tests indicated above were administered each testing date (T1: 12 September & T2: 6 October). For the purposes of determining whether performances from examination date T1 were significantly different on T2, the following conventions were used:

Difference of between 7t and 10t points: significant difference

Difference of greater than 10t points: very significant difference

Mood: Very significantly less depressed, less anxious and less severe PTSD symptoms by test date #2. BDI-II total scored decreased from a raw score of 42 points at T1 (12 September 2009) to only 8 points by T2 (6 October 2009). A raw score of 8 points represents “minimal” depression. A score of 41 points represents “severe” depression. Similarly, STAI trait score diminished 29t points and STAI state score diminished 39t indicating that Adam is now much less anxious. His PCL-C score diminished from a raw score of 74 at T1 to 43 at T2 indicating less severe PTSD symptoms. His MMPI-2 scores of T1 (F 104t, Fb 120t, Fp 48t, D 98t, ANX 90t, DEP 95t, P-K 107) were significantly reduced by T2 (F 76t, Fb 71t, Fp 48t, D 74t, ANX 82t, DEP 68t) indicating for the most part a very significantly improved mood.

Attention: Working Memory at T1 was 39t and at T2 was 48t for a significant improvement and Information Processing Speed was 32t at T1 and 53t at T2 for a very significant improvement.

Memory: Delayed recall of previously learned verbal and nonverbal material has by T2 improved by at least significantly different levels.

Executive Functions: Verbal fluency under both phonemic and categorical conditions had improved very significantly by T2. Switching between dual tracking tasks had improved significantly by T2. Abstract thinking had remained essentially unchanged.

Language: Naming and single word reading vocabulary had remained unchanged.

Motor: A.B. demonstrated very significantly improved motor speed, strength and dexterity for both hands by T2 generally by at least 15t.

Visusospatial: A.B.’s copy of a design was essentially unchanged by T2 in this, a measure of visuoconstructional ability.

Jeffrey M. Gran, Psy.D.

Clinical Neuropsychologist

Jeffrey M. Gran, Psy.D., P.A.